Americans are getting more sleep

Key clinical point: The amount of time people in the United States spend sleeping has increased.

Major finding: On workdays, the prevalence of people who were sleeping 7 hours or less a day decreased by 0.44% per year, and the percentage of people who were sleeping more than 9 hours a day increased by 0.48% per year.

Study details: An analysis of survey responses from 181,335 Americans over 2003-2016.

David Schulman, MD, FCCP, comments: For more than fifteen years, we have had evidence that sleep deprivation is not only associated with increased accident risk, but also other common causes of mortality, including cardiovascular disease and cancer. Despite this knowledge, decades of trending in sleep patterns of the United States population have continued to show declines in total sleep time, which have been attributed to multiple factors, including longer work hours and the pervasive use of electronics, which can serve both as a distraction from sleep and a contributor to circadian dysrhythmia.

Dr. David Schulman, FCCP

The recent article by Basner and Dinges suggests, for the first time, that this trend may be reversing. Although the data suggest a minimal bump in sleep time (of approximately 1 minute per night, slightly more during weeknights than weekend nights), it is at least a move in the right direction. In a related editorial in the same issue of SLEEP, Ogilvie and Patel identify some possible problems with the paper; these include a non-validated tool for data collection, and the possible conflation of time in bed and sleep time. Even if the data are accurate, it is difficult to imagine that such a modest improvement in sleep duration would yield meaningful benefits in terms of daytime function and sleep-related morbidity.

While our work in improving public awareness of sleep deprivation is far from done, perhaps this study is the first sign that a new day is dawning on improved sleep health for the country.

FROM SLEEP

Some Americans began getting more sleep over the period of 2003 through 2016, an analysis of data from the American Time Use Survey (ATUS) has suggested.

Many people living in the United States habitually sleep less than the recommended 7-9 hours each day. “Experimental studies have demonstrated that both acute total and chronic partial sleep restriction in healthy adults are associated with physiological changes that can be considered precursors of manifest diseases (e.g. decreased insulin sensitivity),” noted Mathias Basner, MD, PhD, and David F. Dinges, PhD, both of the division of sleep and chronobiology at the University of Pennsylvania, Philadelphia, in their paper, which was published in the journal Sleep.

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This new study is the first to have demonstrated that large parts of the U.S. population significantly increased their sleep between 2003 and 2016.

The investigators analyzed ATUS responses from 181,335 Americans aged 15 years and older; respondents included in the analysis were not active in the military or residing in institutions such as nursing homes or prisons. In 15- to 20-minute computer-assisted telephone interviews, the survey participants reported the activities they performed over a 24-hour period on a minute-by-minute basis. In-depth analyses only included groups “that showed a significant increase in sleep duration across survey years either on weekdays or weekends (or both): employed respondents, full-time students, and retirees.”

Using this data from ATUS, Dr. Basner and Dr. Dinges found that on workdays the prevalence of people who were sleeping 7 hours or less a day decreased by 0.44% per year (P less than .0001), while the percentage people who were sleeping more than 9 hours a day increased by 0.48% per year (P less than .0001).

Overall, respondents’ sleep increased by an average of 1.40 minutes during a weekday and 0.83 minutes during a weekend day every year.

These findings will be welcome news for organizations, such as the American Academy of Sleep Medicine, the Sleep Research Society, and the Centers for Disease Control and Prevention, that have been campaigning for years to increase sleep time among Americans.